PHYSICAL TREA MENTS January 2017. Volume 6 .

Number 4

Research Paper: Functional Movement Screen in

Elite Boy Basketball Players: A Reliability Study CrossMark

Farzaneh Saki1*

1. Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamedan, Iran.

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Citation: Saki F. Functional Movement Screen in Elite Boy Basketball Players: A Reliability Study. Physical Treatments.
2017; 6(4):211-216. https://doi.org/10.18869/nrip.ptj.6.4.211
: : https://doi.org/10.18869/nrip.ptj.6.4.211

Article info: AB STRACT

Received: 05 Jul. 2016
Accepted: 11 Oct. 2016 Purpose: To investigate the reliability of Functional Movement Screen (FMS) in basketball
players. A few studies have compared the reliability of FMS between raters with different
experience in athletes. The purpose of this study was to compare the FMS scoring between the
beginners and expert raters using video records.
Methods: This is a cross-sectional study. The study subjects comprised 15 elite boy basketball
players. The subjects were randomly selected and each of them completed FMS tests. Three
examiners (two beginners and one expert) watched the recorded video separately and scored the
tests. We used the Kinovea video-analysis software for data analysis. The test-retest reliability
was assessed using Intra-Class Correlation Coefficients (ICCs). Also inter-tester reliability of
each test was computed using Fleiss’ kappa test.
Results: The mean (SD) total FMS score for rater 1, rater 2, and rater 3 were 14.17(1.26),
14.17(1.94), and 13.67(1.67), respectively. There was no significant difference between
examiners with respect to total FMS score (P=0.136). Half of the individual FMS components
had perfect agreement, and rest were categorized as moderate to substantial agreement. The high
and moderate values of ICC as 0.88~0.99 and 0.71~0.91 were observed for intra-rater and inter-
Keywords: rater reliability, respectively.
Functional movement Conclusion: The examiners reported FMS total scores similarly. The inter-rater reliability for
screen, Reliability, the test components had strong agreement. This finding suggests that FMS can be used in the
Basketball evaluation of the abnormal movement patterns of the athletes.

1. Introduction Generally, pre-participation screening methods can be used

P
re-participation physical examination is
well proposed as a part of the international
sport programs and used to identify possible
risk factors leading to disease and injury
such as sudden cardiac death, cardiovascu-
lar disease, and particular musculoskeletal disorders [1-4].
to evaluate the health condition prior to participation in
competition. It focuses on factors that could identify par-
ticular athletic talents or predispose athletes to injury [5-9].
Some researchers have reported several intrinsic and ex-
trinsic risk factors, including muscle strength, structural
malalignments, sex, postural sway, fitness level, and his-

* Corresponding Author:
Farzaneh Saki, MSc.
Address: Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamedan, Iran.
Phone: +98 (918) 8503783
E-mail: F_saki@basu.ac.ir

211
 January 2017. Volume 6 . Number 4
tory of previous musculoskeletal injury that predispose
athletes to injury [10-12]. Additionally, poor neuromuscu-
lar control, weak core stability, and muscular asymmetries
have been proposed as other risk factors for injury. Contra-
lateral muscle imbalances may lead to muscular inhibition
and compensatory strategies [13].
Functional Movement Screen (FMS) is an effective meth-
od that quantitatively measures movement patterns to detect
performance asymmetries [14]. Health experts and coaches
use FMS to screen the athletes at risk of injury with identi-
fication of the asymmetry and abnormal movements [15].
Although FMS has widely been used clinically for evalu-
ating of the muscular asymmetries and flexibility deficits,
there is little information or investigation about the FMS
reliability in athletes. In addition, the traditional sports med-
icine methods have focused on specific joints and muscles,
but new methods like FMS evaluate functional movement.
FMS could help to identify the athletes at risk of injury
and affect the recovery of the injured athletes. At the present
time, there is no agreement that which factors are required
for the return of the athletes to the sports [16]. However, re-
sume to normal sport activity needs the sensory perceptual
motoric integration [7].
It seems that the traditional pre-participation screening
methods does not provide the adequate baseline infor-
mation to assess the individual’s preparedness, without
evaluating the basic aspects of human movements [7].
Movement screening should be performed with specific
performance assessments, since the main objectives of the
pre-participation screening are reducing injuries, increasing
performance, and promoting the quality of movements.
There are two various classifications of reliability mea-
surement, including intra-rater reliability and inter-rater
reliability. The first category of reliability evaluates how
well each examiner or rater can frequently or consis-
tently obtain the similar resulting score. In the second
reliability category, the examiners are more than one and
the degree of agreement compute the extent to which the
examiners get the similar resulting score, when they look
at the same subject [14].
Few researchers have investigated the inter-rater reli-
ability of the FMS score. Schneiders et al. reported the
high reliability between two examiners with the similar
level of experience. Also, Minick et al. have reported
the high reliability between raters with the same level
of experience [5, 17]. Smith et al. have examined reli-
ability of FMS scoring among participants with various
levels of experience and obtained high reliability [18]. In
212 Saki F. Functional Movement Screen in Elite Boy Basketball Players: A Reliability Study. Physical Treatments. 2017; 6(4):211-216.
PHYSICAL TREA MENTS
a similar study, Gribble et al. investigated the inter-rater
reliability between examiners with various level of clini-
cal experience and reported moderate reliability between
examiners [19]. In both studies, subjects were healthy
populations and few studies have evaluated the FMS re-
liability in athletes. Therefore, the purpose of this study
was to evaluate the inter-examiner reliability of the FMS
score among beginners and expert examiners.
2. Materials and Methods
Participants
This study had a cross-sectional design. Study population
comprised the elite boy basketball players of Hamedan City
in 2015 and out of them, 15 subjects were selected random-
ly. Subjects were injury free at the time of the tests. Assess-
ment protocol was explained to the study subjects. Three
raters, including one expert (expert in sport injury and cor-
rective exercise with 2 years’ regular experience at work-
ing with FMS) and 2 novices (graduated physical education
students) scored the FMS performed by the subjects. An
informed consent approved by the Bu-Ali Sina University
Ethics Committee was signed by all subjects. Sample size
was calculated using G power software (α level of 0.05, a
power of 80%, and effect size of 0.5).
Procedures
All subjects performed FMS tests. The FMS included
seven tasks to evaluate functional movement ability [7].
The subjects performed these seven tasks as a standard se-
quence, including overhead squat, hurdle step, in-line lunge,
shoulder mobility, active hamstrings flexibility, trunk, and
rotary stability test. Also, subjects performed three clearing
tasks (lumbar flexion, lumbar extension, and shoulder me-
dial rotation) which evaluate pain. Five of these seven tasks
assessed the asymmetry by comparing both sides [20].
The participants performed dynamic warm up before as-
sessments and then executed seven FMS tasks. They were
received particular instructions about how properly perform
each task. Feedback during the test was prohibited and ath-
lete’s movements were recorded by 2 digital video cam-
eras (model PC-1262, Canon) positioned in the sagittal and
frontal planes (30 frame/second). All subjects performed
each task two times. Kinovea video-analysis software ver-
sion 0.8.15 was used for data analysis.
Three raters scored the test two month later. One of the
raters (expert) rescored the video after a week for comput-
ing intra-tester reliability [18]. According to the quality of
movement, each task was scored from 0 to 3. The score of
PHYSICAL TREA MENTS
Table 1. The Fleiss’ kappa scores
Score
Excellent
Substantial
Moderate
Poor
3 was given to the participant who was able to execute each
task without compensatory motion. The participant, who
performed the task with compensation motion received a
score 2. The score of 1 was given to the participant who
was unable to obtain the position to perform task. The par-
ticipant, who experienced pain during the task, received a 0
score. The total score was computed by summation of each
task score, which ranged from 0 to 21 [7, 16].
Statistical analysis
Data were analyzed by SPSS 20. The Shapiro-Wilks
test was used to assess the data normality distribution.
The ICC (Intraclass Correlation Coefficients) was uti-
lized to compute the inter- and intra-rater reliability of
total FMS scores. The ICC value changes from 0 to 1
[21]. The inter-tester reliability of each task was assessed
by the Fleiss’ kappa (Table 1).
3. Results
Table 2 presents the demographic information of the sub-
jects. The mean (SD) total score of FMS in all examiners is
about 14.06(1.6). Table 3 shows the mean (SD) scores of
total FMS and its components for each rater. The ICC value
for total scores was 0.87(0.71~0.91) which demonstrates
good to excellent agreement between examiners (Table 4).
In 12 individual tests, five tests exhibited excellent agree-
ment between the raters, three tests substantial agreement,
three tests moderate agreement, and one test poor agree-
ment (Table 5).
Table 2. Demographic information of subjects
Variable
Age (y)
Height (cm)
Weight (kg)
Experience (y)
Saki F. Functional Movement Screen in Elite Boy Basketball Players: A Reliability Study. Physical Treatments. 2017; 6(4):211-216.
January 2017. Volume 6 . Number 4
Criteria
80% and higher
60% to 79.9%
40% to 59.9%
Below 40%
PHYSICAL TREA MENTS
4. Discussion
The study findings indicate no significant difference in to-
tal FMS scores between raters. On the contrary, the ability
of three raters in FMS scoring was similar. Also, the total
FMS scores of the three evaluators showed excellent cor-
relation. This is in agreement with earlier research. There is
a high correlation between the raters in total FMS scoring
based on Schneiders et al. study [5]. In addition, Smith et
al. and Onate and Dewey reported high inter-rater reliability
in their studies [18, 22]. The mean total FMS score of the
present study is similar to the findings of Smith et al. and
Chorba et al. studies [13, 18].
We also evaluated inter-rater reliability of the test com-
ponents and half of the FMS tests showed good agreement
based on the study results. Our results are in agreement with
previous research on FMS reliability. Minick et al. found
significant to good inter-rater agreement on each FMS com-
ponent scores when compared 2 beginners and 2 experts
[17]. Moreover, the finding of this study indicated that right
in-line lunge task had the minimum reliability and right ac-
tive leg raise task, the maximum reliability. This result is
consistent with previous studies [23]. Onate and Dewey
reported that right leg raise test had the lowest inter-rater re-
liability [22] whereas this task in the present study showed
100% agreement. FMS is a noninvasive tool to assess
asymmetry of movement abilities in athletes. The impor-
tance of this test is that coaches, athletes, and trainers can
learn this test as a useful method for evaluating fundamental
movement patterns.
Mean±SD
16.33±0.65
181.75±10.03
69.50±0.13
6.25±1.54
PHYSICAL TREA MENTS
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Table 3. Mean±SD of total and component FMS scores by all raters

Test Rater 1 Rater 2 Rater 3

Deep squat 2.17±0.718 2.25±0.622 2.17±0.718

Right hurdle step 1.92±0.515 1.92±0.515 2.00±0.603

Left hurdle step 2.00±0.426 1.92±0.289 2.00±0.426

Right in-line lunge 2.17±0.389 1.92±0.289 2.33±0.492

Left in-line lunge 2.08±0.515 2.00±0.426 2.17±0.577

Right shoulder mobility 2.17±0.835 2.25±0.754 2.17±0.835

Left shoulder mobility 2.25±0.754 2.33±0.651 2.00±0.853

Right hamstring flexibility 2.17±0.718 2.17±0.718 2.17±0.718

Left hamstring flexibility 2.17±0.577 2.25±0.622 2.17±0.577

Trunk stability 2.08±0.669 2.17±0.718 1.92±0.793

Right rotary stability 1.92±0.515 1.83±0.577 1.83±0.452

Left rotary stability 2.00±0.426 2.08±289 2.00±0.426

Total FMS score 14.17±1.26 14.17±1.94 13.67±1.60

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Table 4. Reliability of total FMS Scores

Variable ICC 95% CI

Intrarater (test-retest) 0.96 0.88, 0.99

Interrater 0.87 0.71, 0.91

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Table 5. Agreement of FMS individual test scores (0-3 points)

Test Kappa SE 95% CI Agreement

Deep squat 0.90 0.127 0.65, 1.15 Excellent

Right hurdle step 0.87 0.1272 0.62, 1.12 Excellent

Left hurdle step 0.55 0.1304 0.29, 0.80 Moderate

Right In-line lunge 0.05 0.1477 -0.23, 0.34 Poor

Left In-line lunge  0.72 0.1307 0.46, 0.98 Substantial

Right Shoulder mobility 0.91  0.1202 0.67, 1.14 Excellent

Left Shoulder mobility 0.65 0.1219 0.41, 0.89 Substantial

Right hamstring flexibility 1 0.124 0.75, 1.24 Excellent

Left hamstring flexibility 0.89 0.135 0.62, 1.15 Excellent

Trunk stability 0.55 0.1206 0.31, 0.79 Moderate

Right rotary stability 0.73 0.14 0.46, 1.01 Substantial

Left rotary stability 0.55 0.1304 0.29, 0.80 Moderate

CI: Confidence Interval PHYSICAL TREA MENTS

214 Saki F. Functional Movement Screen in Elite Boy Basketball Players: A Reliability Study. Physical Treatments. 2017; 6(4):211-216.
PHYSICAL TREA MENTS
We suggest that future studies compare the reliability
of real-time and video recorded scoring of the FMS. The
real-time scoring system provides quicker feedback on the
test execution and decreases the time needed for data inter-
pretation. Since video analyzing and FMS scoring is time
consuming, professionals do not use it in the training and
games. Real time analysis is more applicable to give effec-
tive and rapid feedback to majority of the participants.
The present study supports the reliability of FMS test,
which is used to evaluate dysfunction and asymmetry of
movement. In addition, the finding of this research indicates
that total FMS score is reported similarly between the rat-
ers, while the reliability of some test components are not
suitable for evaluating the functional movement, especially
in raters with different experiences. The functional move-
ment screening methods mainly affect the measures taken
for injury prevention and performance enhancement.
The limitation of the present research is the small sample
size. Also the raters could observe the video records of par-
ticipant’s FMS test without any restrictions. This limitation
in video analysis may affect raters’ scoring.
Acknowledgements
This research did not receive any specific grant from
funding agencies in the public, commercial, or not-for-
profit sectors.
Conflict of Interest
The author declared no conflicts of interest.
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216 Saki F. Functional Movement Screen in Elite Boy Basketball Players: A Reliability Study. Physical Treatments. 2017; 6(4):211-216.